The basic steps in an IVF treatment cycle are evaluation and pre-treatment of the couple, ovulation induction, egg retrieval, insemination, fertilization, embryo culture, and embryo transfer.

(1) Evaluation and Pre-Treatment
-  Pre-conception counseling -  Anatomic assessment

A HSG may be recommended if it has not been already done.
Operative techniques such as laparoscopy and hysteroscopy are some times suggested if the HSG is abnormal

-  Hormonal tests

-  Semen analysis and sperm storage

This will determine whether IVF or ICSI will be used for in vitro fertilization.

A urology consultation for the male partner is sometimes suggested, for example if surgery is needed to obtain sperm.

-  Testing both partners for infectious diseases

Screening both partners for infectious diseases like HIV and hepatitis that can be transmitted from one partner to another or from mother to fetus before birth.

(2) Ovulation Induction
A woman undergoing IVF is given fertility drugs to enhance the growth of the ovarian follicles, so she can develop more mature eggs

(3) Hormonal Tests & Ultrasound scan
The developing follicles are monitored for their maturity by measuring the follicle size through an ultrasound and correlating the finding with the blood concentration of the patient's estradiol value drawn the same day.

(4) Ultrasound guided Egg Retrieval
After ovulation induction is achieved, the next step in the IVF process involves an ultrasound guided egg retrieval, which is carried out under light anaesthesia. The egg retrieval procedure takes about 30-45 minutes.

(5) Insemination of oocytes: IVF/ICSI

IVF ICSI
A semen sample from the male partner is obtained after the egg retrieval procedure. The man's semen is then washed and prepared to obtain actively motile sperm. The prepared sperm is then used to inseminate the eggs by IVF /ICSI in the culture media.

(6) A normally fertilized oocyte
The day after egg retrieval and insemination/injection the embryologist will examine the eggs and check for fertilization. A fertilized egg will have 2 nuclei in the center, one from the egg and one from the sperm.

(7) Embryo Culture
The fertilized eggs (embryos) will spend from 3-5 days in the laboratory to allow them to develop into the eight-cell or blastocyst stage, at which time they are ready to be transferred into the woman's uterus.

(8) Assisted Embryo Hatching
Prior to implantation, the embryo has to escape from its protective shell known as the zona pellucida by a process known as hatching. If this process is not completed properly, implantation will fail and a pregnancy cannot occur. We offer the Laser technology for Assisted Hatching (LAH), where a laser beam is focused over the Zona pelucida making a small opening of about 20 microns to facilitate embryo hatching.

This technique is particularly useful in cases where women show embryos with a thick zona and also in cases with previous failed cycles.

(9) Embryo Transfer
The resulting embryos are placed back in the woman's uterus using a fine catheter through a simple procedure called embryo transfer.

(10) Cryopreservation/Embryo Freezing
Most women who undergo hormonal stimulation for an IVF or related procedure of Assisted Reproduction produce more eggs than necessary for transfer during that cycle. The extra-fertilized eggs may be frozen or "cryopreserved" and stored for future transfer if she does not achieve pregnancy initially. Even if pregnancy is achieved during the initial stimulated cycle, the couple can choose to transfer the extra frozen embryos several years later in order to become pregnant again.

(11) After Embryo Transfer
We recommend that you take rest on the day of the embryo transfer and for 2 days following the transfer. Strenuous exercises such as jogging & swimming should be avoided until the pregnancy is confirmed. Otherwise, the patient is free to return to her regular activities. The patient can take a regular home-made diet. We recommend avoiding eating papaya and pineapple.

(12) A Pregnancy test is done about 14 days after embryo transfer.